Hypertension is associated with a wide range of disorders. One hypertensive disorder is pre-eclampsia (PE). PE is a serious complication of pregnancy characterized by high blood pressure (diastolic ≥90 mmHg) and proteinuria (≥300 mg in 24 hr) after 20 weeks of gestation. PE is sometimes or often accompanied by edema (e.g., pulmonary edema), encephalopathy, seizures, renal insufficiency, liver failure, intrauterine growth restriction (IUGR), and premature birth, the latter two prejudicing the survival and well-being of the fetus and neonate. PE occurs in about 5-10% of pregnancies, and is a major cause of maternal and fetal morbidity and mortality worldwide. The only known effective therapy for PE is early delivery of the newborn.
In addition, fibrosis contributes to many disorders. One fibrotic disorder is diabetic nephropathy (DN), which is also characterized by high blood pressure. DN affects about 15-25% of type 1 diabetes patients and about 30-40% of type 2 diabetes patients, and is the most common cause of end-stage renal disease (ESRD) in the world. Clinical DN involves a series of pathological events, including initial increases in intraglomerular capillary pressure and glomerular filtration rate (GFR), glomerular hypertrophy, mesangial matrix expansion, thickening of the glomerular basement membrane, arteriolar hyalinosis, nodular glomerulosclerosis, tubulointerstitial fibrosis and injury, and proteinuria (including albuminuria). For instance, scarring of glomerular capillaries (glomerulosclerosis) impairs the filtering process of the renal corpuscle and allows proteins to leak from the blood into the urine, resulting in proteinuria. Poor glycemic control in DN patients exacerbates the disease progression to renal insufficiency and decline in GFR that can lead to ESRD.